Development of a Practical Costing Method for Hospitals

PENGYU CAO, SHIN-ICHI TOYABE and KOUHEI AKAZAWA

Division of Information Science and Biostatistics, Department of Medical Informatics and Pharmaceutics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

To realize an effective cost control, a practical and accurate cost accounting system is indispensable in hospitals. In traditional cost accounting systems, the volume-based costing (VBC) is the most popular cost accounting method. In this method, the indirect costs are allocated to each cost object (services or units of a hospital) using a single indicator named a cost driver (e.g., Labor hours, revenues or the number of patients). However, this method often results in rough and inaccurate results. The activity based costing (ABC) method introduced in the mid 1990s can prove more accurate results. With the ABC method, all events or transactions that cause costs are recognized as “activities”, and a specific cost driver is prepared for each activity. Finally, the costs of activities are allocated to cost objects by the corresponding cost driver. However, it is much more complex and costly than other traditional cost accounting methods because the data collection for cost drivers is not always easy. In this study, we developed a simplified ABC (S-ABC) costing method to reduce the workload of ABC costing by reducing the number of cost drivers used in the ABC method. Using the S-ABC method, we estimated the cost of the laboratory tests, and as a result, similarly accurate results were obtained with the ABC method (largest difference was 2.64%). Simultaneously, this new method reduces the seven cost drivers used in the ABC method to four. Moreover, we performed an evaluation using other sample data from physiological laboratory department to certify the effectiveness of this new method. In conclusion, the S-ABC method provides two advantages in comparison to the VBC and ABC methods: (1) it can obtain accurate results, and (2) it is simpler to perform. Once we reduce the number of cost drivers by applying the proposed S-ABC method to the data for the ABC method, we can easily perform the cost accounting using few cost drivers after the second round of costing.

keywords —— medical costs; costing accuracy; volume based costing; activity based costing; simplified cost accounting

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Tohoku J. Exp. Med., 2006, 208, 213-224

Received September 22, 2005; revision accepted for publication December 27, 2005.
Correspondence: Pengyu Cao, Department of Medical Informatics, Niigata University Medical Hospital,Asahi-machi 1-754, Niigata 951-8520, Japan.

e-mail:caopeng@med.niigata-u.ac.jp